Assessing Paediatric Hrqol in Diabetes: Semantic and Pilot Validation Study of the Portuguese Versions of DISABKIDS-DM ConditionSpecific Module

Abstract

This study aimed to semantically validate the Portuguese versions of the diabetes module of a pediatric health-related quality of life assessment instrument – DISABKIDS-DM – and to preliminarily explore their main psychometric properties. Materials and Methods − Two samples of children (8-12 yo) and adolescents (13-18 yo) with Type 1 diabetes and their caregivers participated in the semantic validation (n=36) and in the pilot study (n=160) and filled out the DISABKIDS-DM, the semantic validation questionnaires and the Strengths and Difficulties Questionnaire. Using classical statistical validation procedures, the reliability, interrater consistency, and construct, discriminant, convergent and divergent validity were analyzed. Results − The findings support the relevance, comprehensibility and adequacy of the Portuguese versions. Both the self and proxy versions exhibited adequate levels of reliability; interrater consistency; and convergent, divergent and discriminant validity. The instrument differentiated between HbA1c groups, with children/adolescents with lower levels reporting better HRQoL, and between groups with and without comorbidity, with participants with other chronic diseases showing worse HRQoL. The instrument did not discriminate between the gender and time of diagnosis categories. Children and adolescents tended to report higher levels of HRQoL than their parents. Conclusion − These results reinforce the importance of cross-cultural validation procedures to ensure the equivalence of pediatric HRQoL measures, particularly in the context of diabetes-specific instruments. More research is needed, with a larger and more diverse sample, to study the factorial structure. The use of the questionnaires should be encouraged in both pediatric clinical settings and research.